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Category Archives: E/M Coding & Auditing

AI Auditing: Walking Backwards Towards Home

E/M Coding & Auditing, ICD-10, Procedural Coding & AuditingBy NAMASOctober 12, 2023

  October 13, 2023 | By J. Paul Spencer, CPC, COC Way back in 1976, as an elementary school kid in the suburbs of Philadelphia, I came across a book in the library called 2010: Living in the Future. In my then-current world of AMC Pacers and seersucker suits, the book promised great things. Apparently,…

AMA and NCCI: Differences in Coding Policy and Payer Policy Using Modifier 25

Compliance, E/M Coding & Auditing, Payer RulesBy NAMASOctober 3, 2023

  October 3, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Have you seen the new AMA Smart Brief on Modifier 25 that was released on August 17th? That’s what I want to talk to you about today. I want to break down the information because I specifically noticed there is a stark…

Understanding MDM in 2021 – Part 1

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASSeptember 4, 2020

September 4, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Is anybody not aware of the Evaluation and Management (E/M) changes coming in January 2021? Have you asked your administrator, managers, front office, back office, and providers if they are ready for these major changes? Anybody that touches CPT® 99202-99215…

Critical Care Billing: It’s the Little Things

Compliance, E/M Coding & Auditing, Procedural Coding & AuditingBy NAMASFebruary 19, 2021

  February 19, 2021 | By David Carpenter   Critical care billing is relatively simple. Documentation requires three items – The patient is critically ill. What the provider is doing to treat or prevent organ system failure or compromise. How much time the provider spent providing critical care. While critical care billing is relatively simple,…

The Importance of Skepticism

E/M Coding & Auditing, ICD-10, Payer RulesBy NAMASJanuary 10, 2020

  January 10, 2020 | By David Glaser     Skepticism is a vital trait in the coding and billing process. Constant questioning is necessary because when you receive guidance from consultants and contractors it may be both clear and categorical, but it’s possible that upon objective review, you will realize it is also cockamamie. For…

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